What is the relationship between homelessness and substance abuse?

Background: Substance abuse is present throughout the UK, spanning all areas of society. However, its prevalence lies mostly where there is deprivation and poverty, making those living in such conditions more likely to succumb to drugs and the detrimental consequences that follow. It has been established that homeless people are more susceptible to ill health than the general public, given the environment and lifestyle in which they live. The use of illicit drugs that is seen in a high percentage of homeless people contributes greatly to this chaotic lifestyle, exacerbating ill health and instigating a life far from that accepted by society.

Aims: To explore the abundant problem of substance abuse and its harmful effect on the social, psychological and health aspects of the homeless population. To explore NHS and other services available to homeless people and their effectiveness in managing substance abuse.

Method: A database search was conducted to access publications on the subject of homelessness and substance abuse. Databases such as MEDLINE, EMBASE, CINAHL and BNI were used. An internet search was also conducted using key terms related to the area of study. A hands on approach was also taken, consisting of visits to a number of services for the homeless and for substance abusers in the North West.

Results: Homeless substance abusers are vulnerable to a wide range of health and social problems, and have support needs that scope way beyond housing and drug support. There are inequalities with regards to the delivery of healthcare, and many homeless people suffer from discrimination by the general public and health professionals alike. Due to the barriers faced when accessing mainstream care, an increasing number of practices are attempting to provide clinics aimed at the homeless population. Drug services available in the North West aim to promote safe use of injecting equipment in a bid to reduce the immediate risks of injecting.

Conclusion: Owing to the high levels of support the average homeless person requires, success in managing drug problems and integrating an individual back into society is best achieved when multiple organizations liaise with one another to provide holistic care.